Symptoms and causes

Symptoms

Atopic dermatitis on the legs

Atopic dermatitis on the legs

Atopic dermatitis can cause small, red bumps, which can be very itchy. When scratched, the bumps may leak fluid and crust over. Atopic dermatitis most often occurs where your skin flexes — inside the elbows, behind the knees and the front of the neck.

Atopic dermatitis on the chest

Atopic dermatitis on the chest

Inflammation caused by atopic dermatitis can cover large areas of the body, such as the chest, or be limited to a few small locations.

Infantile eczema

Infantile eczema

In infants, atopic dermatitis (infantile eczema) usually appears as red, itchy patches that are associated with very dry skin.

Red to brownish-gray patches, especially on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees, and in infants, the face and scalp

Small, raised bumps, which may leak fluid and crust over when scratched

Thickened, cracked, scaly skin

Raw, sensitive, swollen skin from scratching

Atopic dermatitis most often begins before age 5 and may persist into adolescence and adulthood. For some people, it flares periodically and then clears up for a time, even for several years.

When to see a doctor

See a doctor if you or your child:

Is so uncomfortable that the condition is affecting sleep and daily activities

Has a skin infection — look for red streaks, pus, yellow scabs

Continues to experience symptoms despite trying home remedies

Seek immediate medical attention for your child if the rash looks infected and he or she has a fever.

Causes

Healthy skin helps retain moisture and protects you from bacteria, irritants and allergens. Eczema is related to a gene variation that affects the skin's ability to provide this protection. This allows your skin to be affected by environmental factors, irritants and allergens.

In some children, food allergies may play a role in causing eczema.

Risk factors

The primary risk factor for atopic dermatitis is having a personal or family history of eczema, allergies, hay fever or asthma.

Complications

Complications of atopic dermatitis (eczema) may include:

Asthma and hay fever. Eczema sometimes precedes these conditions. More than half of young children with atopic dermatitis develop asthma and hay fever by age 13.

Chronic itchy, scaly skin. A skin condition called neurodermatitis (lichen simplex chronicus) starts with a patch of itchy skin. You scratch the area, which makes it even itchier. Eventually, you may scratch simply out of habit. This condition can cause the affected skin to become discolored, thick and leathery.

Skin infections. Repeated scratching that breaks the skin can cause open sores and cracks. These increase the risk of infection from bacteria and viruses, including the herpes simplex virus.

Irritant hand dermatitis. This especially affects people whose work requires that their hands are often wet and exposed to harsh soaps, detergents and disinfectants.

Allergic contact dermatitis. This condition is common in people with atopic dermatitis.

Eichenfield LF, et al. Current guidelines for the evaluation and management of atopic dermatitis: A comparison of the Joint Task Force Practice Parameter and American Academy of Dermatology guidelines. Journal of Allergy and Clinical Immunology. 2017;139:S49.

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